ISLEMORADA, UNITED STATES: A sign sits outside the Flagler Cafe in Islemorada, FL 23 September in preparation for Hurricane Georges as residents and tourists remove their boats from the Florida keys. Georges, a category-one hurricane is expected to reach landfall in the Florida Keys sometime late 24 September a mandatory evacuation for the lower keys has already been put into effect. AFP PHOTO/RHONA WISE (Photo credit should read RHONA WISE/AFP/Getty Images) (Photo: RHONA WISE AFP/Getty Images)

MIAMI, FL - AUGUST 25: A resident (bottom right) looks out of his apartment 25 August 1992 that had its walls blown away by Hurricane Andrew. About 50,000 Dade county residents are without their homes due to Hurricane Andrew, which struck the area 24 August 1992. (Photo credit should read ROBERT SULLIVAN/AFP/Getty Images) (Photo: ROBERT SULLIVAN AFP/Getty Images)

HOMESTEAD, FL - AUGUST 25: Susanne Miller (R) and Cheryl Winchester of Homestead clear the rubble from their pet supply store in Homestead, Florida 25 August 1992 as Floridians began cleaning up after Hurricane Andrew. Twelve people were killed by the storm, which left more than 50,000 homeless. (Photo credit should read BOB PEARSON/AFP/Getty Images) (Photo: BOB PEARSON AFP/Getty Images)

21st October 1926: The coastline in Miami, Florida, following the great hurricane, which brought an end to the Florida land boom. (Photo by R. B. Holt/MPI/Getty Images) (Photo: R. B. Holt Getty Images)

KENDALL, FL - AUGUST 24: Vidal Martinez holds his head 24 August 1992 while viewing the aftermath of Hurricane Andrew in front of what is left of his trailer at the Flowers Trailer Park, Florida. Hurricane Andrew smashed ashore before dawn 24 August devastating southern Florida. (Photo credit should read ANDY ITKOFF/AFP/Getty Images) (Photo: ANDY IKTOFF AFP/Getty Images)

379759 09: Flood victims push a grocery cart down a flooded street October 5, 2000 in Miami after receiving food, fresh water, and ice from The Salvation Army. Heavy rains from a tropical depression swamped most of Miami with over a foot of water and left more than 40,000 residents without water or electricity. Florida Governor Jeb Bush declared a state of emergency for Miami-Dade County. (Photo by Robert King/Newsmakers) (Photo: Robert King Getty Images)

MIAMI, FL ? Late-1920s: The remains of Fulford-Miami Speedway after it was destroyed by a Category 4 hurricane on September 17, 1926. The track was a 1.25-mile banked board track built by Carl F. Fisher, who had previously built the Indianapolis (IN) Motor Speedway. The track was designed by 1911 Indy 500 winner Ray Harroun. The only race at the track was held on February 22, 1926, and was won by Peter DePaolo in the same Duesenburg that he had driven to victory in the 1925 Indianapolis 500. Note that the car and driver names from that lone race can still be seen painted along the inside front stretch wall. Much of the lumber from the speedway was later used to help rebuild the City of Miami. (Photo by ISC Images & Archives via Getty Images) (Photo: RacingOne ISC Archives via Getty Images)

FLORIDA CITY, UNITED STATES: Florida State Troopers direct traffic outside FLorida City, Florida 26 September as residents of the Florida Keys wait on US1 for hours to return to their homes to assess the damage left by Hurricane Georges. The Keys were under a mandatory evacuation 25 September as Hurricane Georges ripped through the middle and lower keys. AFP PHOTO RHONA WISE (Photo credit should read RHONA WISE/AFP/Getty Images) (Photo: RHONA WISE AFP/Getty Images)

UNITED STATES - MARCH 05: Scene Of The Wreck After A Hurricane Passed Through Biscayne Bay, Florida, On November 5, 1935. (Photo by Keystone-France/Gamma-Keystone via Getty Images) (Photo: Keystone-France Gamma-Keystone via Getty Images)

UNITED STATES - AUGUST 12: The surf is turbulent at Tampa, Fla., where a massive evacuation is underway as Hurricane Charley, packing winds as high as 105 mph, barrels toward the Gulf Coast. (Photo by John Roca/NY Daily News Archive via Getty Images) (Photo: New York Daily News Archive NY Daily News via Getty Images)

MIAMI, FL - AUGUST 26: A sign in front of a house in the Cutler Ridge area damaged by Hurricane Andrew reads "We will survive" 26 August 1992. Hurricane Andrew left more than 50,000 people homeless and caused billions of dollars of damage. (Photo credit should read ANDREW ITKOFF/AFP/Getty Images) (Photo: Andrew ITKOFF AFP/Getty Images)

A resident emerges from his home and braves high winds and waist-deep water to assess the damage that Hurricane Betsy has done to his property, Miami Beach, Florida, September 13, 1965. His car is half-submerged in floodwater. Betsy caused $1.42 billion worth of damage in the Bahamas, Florida, and Louisiana, earning the storm the nickname "Billion Dollar Betsy."(Photo by Hulton Archive/Getty Images) (Photo: Hulton Archive Getty Images)

MIAMI, FL - AUGUST 24: A sailboat sits on its side 24 August 1992 at the Dinner Key Marina in Florida after it was lifted out of the water by Hurricane Andrew. The hurricane smashed ashore before dawn 24 August 1992 with 160-mph winds. At least 12 people were killed. (Photo credit should read AFP PHOTO Andy ITKOFF/AFP/Getty Images) (Photo: Andrew ITKOFF AFP/Getty Images)

Elderly man picking over the tangled wreckage of home as he tries to salvage personal items from the devastation at the DeSoto Mobil Home Park. (Photo by Thomas S. England//Time Life Pictures/Getty Images) (Photo: Thomas S. England Time & Life Pictures/Getty Image)

FLORIDA CITY, UNITED STATES: Democratic presidential candidate Bill Clinton gets a kiss from three-year-old Mercedes Williams (L), while holding two-year-old Glenn Moore Jr. 03 September, 1992. The children were at an aid station 03 September, in the aftermath of Hurricane Andrew, where they met Clinton who was touring the devastated areas of South Florida. (Photo credit should read ROBERT SULLIVAN/AFP/Getty Images) (Photo: ROBERT SULLIVAN AFP/Getty Images)

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People living in 10 largely rural counties in the Deep South and near the Gulf Coast are those most vulnerable to hurricanes, according to recent research by Direct Relief, a California-based non-profit organization.

Not strictly focused on where hurricanes hit land, the group looked at the relationship between the frequency and intensity of hurricanes relative to social vulnerability – with factors such as poverty, access to social services, an aging population and higher mobility problems – being taken into account.

"The research looked at the likelihood that people would be overwhelmed by an event," said Andrew Schroeder, Direct Relief's director of research and analysis. This included the likelihood of people not being able to get out of the way of the storm, which could result in injury, sickness or death.

Overall, the study looked at the communities' ability to prepare for, respond to and recover from hurricanes.

Located in Goleta, Calif., Direct Relief provides medical assistance and supplies to people affected by poverty and natural disasters across the USA and in 72 countries worldwide.

The list was created "to help us understand where we need to be positioned for hurricane season," Schroeder said. "Hurricanes aren't just natural disasters, they're social phenomena, too.

"Effective emergency response takes into account complex relationships between social factors and natural events," he added.

The study findings are based on the past 10 years of hurricanes, according to Direct Relief. They did not include impacts of tropical storms, which are not as strong as hurricanes. While not a peer-reviewed study in a journal, it is based on extensive research that was peer-reviewed, Schroeder said..

Surprisingly, the "top 10" counties are not along the coast, and many are actually well inland. This is because the people who live near the coast tend to be wealthier and are better able to prepare for the storms, Schroeder said. Inland counties in Florida, Mississippi and Louisiana were areas that were most concerning.

Also, while coastal areas see major impacts from hurricanes, inland areas can also receive heavy rain that leads to flooding, high winds and tornadoes after the storm makes landfall.

Houston County was the one major metropolitan area that made the list. The sprawling metropolis of Houston has the high rates of inequality, he said. It also has a large population of elderly people, as well as immigrants, which contribute to the region's vulnerability.

The top 10 counties list mostly jibes with the three most hurricane-prone states in the country: Since 1851, the top three states for hurricane landfalls are Florida (114), Texas (63) and Louisiana (54), according to data from the Atlantic Oceanographic and Meteorological Laboratory in Miami.

And while Mississippi has only seen 16 direct hurricane hits on its coastline since 1851, many more hurricanes have affected inland portions of the state, which is the nation's poorest as rated by the U.S. Census Bureau.

The research by Direct Relief also aligns with recent efforts by scientists from the National Center for Atmospheric Research and National Oceanic and Atmospheric Administration to bring more of an understanding of social science into the spheres of meteorology and climatology.

Direct Relief leaders last week announced what they said was the world's largest hurricane preparation program of its kind, as it shipped "hurricane preparedness packs" to 63 health facilities near the Gulf and Atlantic coasts, the Caribbean, Central America and the Philippines.

The packs contain more than $1 million in medical resources, and each one holds enough medical supplies to treat 100 patients for a variety of conditions, from basic trauma injuries to chronic illnesses, for a 72-hour period.